目的分析国内10省市孕妇孕期IgG血型抗体效价与ABO新生儿溶血病(Hemolytic disease of newborn,HDN)的相关性。方法对本市300名孕妇及其丈夫进行ABO血型定型;对孕妇血清进行IgG抗-A和(或)抗-B效价测定;孕妇分娩后,对有HDN临床指征的患...目的分析国内10省市孕妇孕期IgG血型抗体效价与ABO新生儿溶血病(Hemolytic disease of newborn,HDN)的相关性。方法对本市300名孕妇及其丈夫进行ABO血型定型;对孕妇血清进行IgG抗-A和(或)抗-B效价测定;孕妇分娩后,对有HDN临床指征的患儿进行ABO血型定型及HDN 3项试验;分析本市及国内其他9省市孕妇IgG血型抗体效价与HDN的相关性。结果本市300名孕妇的ABO血型均为O型,其丈夫为非O型(A、B或AB型)。国内10省市HDN的发生率均随孕妇IgG血型抗体效价的升高而升高;各效价组HDN的发生率10省市间相比,差异均有统计学意义(P均<0.05);合计国内10省市数据,孕妇IgG血型抗体不同效价组间HDN的发生率均有统计学意义(P<0.05),孕妇IgG血型抗体效价与HDN的发生率呈正相关(r=0.866,P<0.05),以抗体效价32～64的HDN发生率增幅最大(440%)。结论孕妇IgG血型抗体效价可作为评估HDN发生风险的指标之一,但并非唯一性指标,还应结合其他检测结果及孕妇临床状况综合分析,做出判断。展开更多
Aim: This study was aimed to review and establish the practice of exchange transfusion (ET) with whole blood reconstituted (WBR) in hemolytic disease of newborn (HDN). Objectives: To observe fall in indirect serum bil...Aim: This study was aimed to review and establish the practice of exchange transfusion (ET) with whole blood reconstituted (WBR) in hemolytic disease of newborn (HDN). Objectives: To observe fall in indirect serum bilirubin, correction of anemia and comparison with related studies. Background: Hemolytic disease of the Newborn is characterized by presence of IgG antibodies in maternal circulation, which causes hemolysis in the fetus by crossing the placenta and sensitizing red cells for destruction by macrophages in the fetal spleen with consequent hyperbilirubinemia. Exchange transfusion with or without phototherapy is the method of choice for treating the newborn with on going hemolysis Methods/Materials: Sample size consisted of 110 neonates in whom 119 exchange transfusions were carried out with WBR. WBR was prepared by suspending O Rhesus-D (RhD) positive/negative cells (compatible with neonate’s/ mother’s serum) in AB plasma. Double volume exchange transfusion(s) were carried out through umbilical vein by push-pull technique. Results: Out of 110 cases, 61 (55.5%) were of RhD HDN whereas ABO and other group HDN cases were 30 (27.3%) and 19 (17.3%) respectively. An average post-ET fall in indirect serum bilirubin by 54.6% and correction of anemia by3.7 gm/dl were reported in the study. Conclusion: An average post-ET fall in indirect serum bilirubin and correction of anemia was found to be more significant when compared to other studies. Hence we recommend exchange transfusion in HDN with WBR to obtain reasonable fall in indirect serum bilirubin and high average rate of correction of anemia.展开更多
文摘目的分析国内10省市孕妇孕期IgG血型抗体效价与ABO新生儿溶血病(Hemolytic disease of newborn,HDN)的相关性。方法对本市300名孕妇及其丈夫进行ABO血型定型;对孕妇血清进行IgG抗-A和(或)抗-B效价测定;孕妇分娩后,对有HDN临床指征的患儿进行ABO血型定型及HDN 3项试验;分析本市及国内其他9省市孕妇IgG血型抗体效价与HDN的相关性。结果本市300名孕妇的ABO血型均为O型,其丈夫为非O型(A、B或AB型)。国内10省市HDN的发生率均随孕妇IgG血型抗体效价的升高而升高;各效价组HDN的发生率10省市间相比,差异均有统计学意义(P均<0.05);合计国内10省市数据,孕妇IgG血型抗体不同效价组间HDN的发生率均有统计学意义(P<0.05),孕妇IgG血型抗体效价与HDN的发生率呈正相关(r=0.866,P<0.05),以抗体效价32～64的HDN发生率增幅最大(440%)。结论孕妇IgG血型抗体效价可作为评估HDN发生风险的指标之一,但并非唯一性指标,还应结合其他检测结果及孕妇临床状况综合分析,做出判断。
文摘Aim: This study was aimed to review and establish the practice of exchange transfusion (ET) with whole blood reconstituted (WBR) in hemolytic disease of newborn (HDN). Objectives: To observe fall in indirect serum bilirubin, correction of anemia and comparison with related studies. Background: Hemolytic disease of the Newborn is characterized by presence of IgG antibodies in maternal circulation, which causes hemolysis in the fetus by crossing the placenta and sensitizing red cells for destruction by macrophages in the fetal spleen with consequent hyperbilirubinemia. Exchange transfusion with or without phototherapy is the method of choice for treating the newborn with on going hemolysis Methods/Materials: Sample size consisted of 110 neonates in whom 119 exchange transfusions were carried out with WBR. WBR was prepared by suspending O Rhesus-D (RhD) positive/negative cells (compatible with neonate’s/ mother’s serum) in AB plasma. Double volume exchange transfusion(s) were carried out through umbilical vein by push-pull technique. Results: Out of 110 cases, 61 (55.5%) were of RhD HDN whereas ABO and other group HDN cases were 30 (27.3%) and 19 (17.3%) respectively. An average post-ET fall in indirect serum bilirubin by 54.6% and correction of anemia by3.7 gm/dl were reported in the study. Conclusion: An average post-ET fall in indirect serum bilirubin and correction of anemia was found to be more significant when compared to other studies. Hence we recommend exchange transfusion in HDN with WBR to obtain reasonable fall in indirect serum bilirubin and high average rate of correction of anemia.
